World Neurosurg
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Cystic dilation of the ventriculus terminalis (CDVT) is a rare anatomic variation that and may become symptomatic. Literature regarding CDVT is limited, and thus the clinical characteristics and management strategy of CDVT are unclear. Here we report 6 cases of CDVT seen in our institution, and provide a review of the current literature. ⋯ CDVT is an extremely rare cause of conus medullaris syndrome with an unclear treatment strategy. Our successful surgical management of 6 cases through cystic-subarachnoid shunting using a T-catheter for CDVT drainage provides a potential option for treating CDVT.
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The outcomes of repeat stereotactic radiosurgery (SRS) after failure of previous SRS are not well established. We report our overall experience using SRS for the retreatment of locally recurrent brain metastases. ⋯ Repeat SRS is feasible for select patients, particularly for those with tumor volume ≤4 cm3. Further evaluation is needed to establish the most appropriate treatment doses and volumes for this approach.
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Combined hyperactive dysfunction syndrome (HDS) is defined as the combination symptoms arising from overactivity in cranial nerves, specifically, trigeminal neuralgia (TN), hemifacial spasm (HFS), and glossopharyngeal neuralgia (GPN), without an obvious explanatory structural lesion. This study retrospectively analyzes the clinical characteristics of combined HDS treated with microvascular decompression (MVD) in a single institution. ⋯ Combined HDS is a rarely occurring syndrome usually observed in older females, and the most common types are combined TN-GPN and combined TN-HFS. Age and gender seemed to be causes for developing combined HDS, and MVD shows potential as a favorable treatment choice.
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Hemimasticatory spasm is a very rare disorder of the trigeminal motor rootlet that is characterized by a paroxysmal involuntary contraction of the jaw-closing muscles. The mechanisms for hemimasticatory spasm remain unclear, and an efficient treatment strategy still needs to be developed. ⋯ Our report shows that a single venous compression may be also responsible for idiopathic hemimasticatory spasm which can be cured by microvascular decompression. This is the first report on hemimasticatory compressed by a single vein in the world.
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Patients with cavernous sinus dural arteriovenous fistulas (CS dAVFs) with cortical venous varix are indicated for aggressive treatment because of the associated risk for intracranial hemorrhage. ⋯ The transcortical vein approach enables occlusion of CS dAVF with isolated cortical venous drainage and may be a valuable alternative approach for some cases needed emergency craniotomy.